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umdelisl

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I’m posting here because I don’t know where else to go. I have read the stickies, and I am very much struggling after being told by a neurologist that my EMG was abnormal today.

I’m a 32 year old mother of two beautiful boys (1 and 3 years old). Along with my husband, they are my whole world. I always felt that I never had truly found my calling in life until I was blessed enough to become a mother.

Around 3 months ago, I began experiencing chronic twitching in my calves and feet. I made the mistake of googling “muscle twitching”, thinking there must be a simple answer to my issues. What I read terrified me. Over the 3 months, the twitching spread to my abdomen, back, arms and face... and I’ve began to experience cramping...

The twitching led me to my GP, who assured me it was likely a vitamin or mineral imbalance, ran some bloodwork and sent me home. It all came back normal. I then discovered that my right calf (my dominant one) was 2 cm less in diameter than my left, so I went back to my GP. She measured, and said that it was within the normal range. I explained my anxiety and she indicated that she would order an EMG, but she was sure it would come back normal.

Fastforward to today, and I had my EMG. The neurologist that performed it told me it was abnormal, and asked if I had a back injury (I do not). I don’t have the report yet, as the neurologist said he would get it back to my Doctor before the end of the week. He saw me tear up and said, “some motor neuron problems are treatable, and some are not”. He said my GP needed to refer me to a neurologist for further follow up, and sent me on my way. He also told me my reflexes were normal.

I phoned my GP, and they were nice enough to set up an appointment on Monday for me, and hopefully they will get the report by then. It’s little solace, as I know this is going to turn into a very long waiting game. One I really don’t know how to handle or cope with...

I haven’t noticed any signs of weakness, but the abnormal EMG has sent me into a tailspin. I’m concerned that my smaller right calf is actually atrophy, as my GP basically completely dismissed all of my concerns when I came to her with the twitching.

I have no one to talk to, because I don’t want to scare them. My husband is the eternal optimist, and doesn’t worry about much, and won’t even discuss the health issues I am experiencing. I want to be there to see my beautiful boys grow up.

I truly appreciate those that take the time to comment, especially those with ALS, and those awaiting diagnosis. My heart goes out to each and every one of you and your families...
 
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Twitching is far too common to be diagnostic of anything!

No one is symmetrical.

An EMG can be abnormal and have nothing to do with ALS.

You're jumping the gun; chill and stay the hell off of Google until you see your Doctor.
 
Lots of things can cause an abnormal EMG. To name a few — pinched nerves, spinal stenosis, primary muscle disorders, trauma, metabolic problems. In the absence of muscle function failure, motor neuron diseases such as ALS are really not a concern. Twitching is non specific and non diagnostic. I realize you’re scared, but it would be extremely unlikely for you to have ALS.
 
Thank you both for your replies. I’m having a rough day, and know this could be a very long process going forward. How did you cope?
 
As noted above abnormal emg could be anything and even without back pain sounds like it could be spinal based on the comment. It is too bad that you were given enough information to be alarming but not enough to know what is going on.

It is really urgent not to get ahead of yourself so please don’t focus on ALS when there is a good chance it isn’t on the table.

Consider calling your doctor tomorrow. They may have your results. Honestly if it looked like ALS I would have expected your doctor to have already called bad news travels fast and goes to the top of the pile
 
Can anyone help me understand my EMG report?

I’m hoping someone can provide me with a bit of insight as to what my EMG report means, I’ve attached the table, and past that the report reads:

“NCS did not confirm a large fiber sensory neuropathy. The EMG did show polyphasic potentials in multiple, bilateral nerve root distributions.”

I’m only now being referred to a neurologist (and will likely have a lengthy wait ahead of me) for a full clinical workup. My GP sent me for the EMG only because I was anxious and was sure that I’d have a clean EMG and that the twitching was due to anxiety. She gave me a copy of the report, but didn’t really explain it other than saying “ALS was on the list of things it could be, but to try not to worry”... Easier said than done with a baby and toddler at home.

Any insight is much appreciated. I do understand that no one here is a MD on here, but I am hoping that maybe someone has a better understanding of what this means than I do.
 

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Mod note: Please keep posting in your original thread. This helps members here see the whole picture and allow for more informed feedback.
 
When you look at the report you see there is no spontaneous activity. This is the part that shows active denervation. You don’t have it. PALS do.

What you do have is some evidence of chronic denervation - generally an old injury but it is seen also in people with no known injury or pain. That is why you were asked about your back.

We see similar reports here often by worried folk and they never seem to come back and report being diagnosed. Especially as you have no clinical weakness there is no reason to suspect ALS. I am sure your gp is wonderful but they are not a neurologist let alone a neuromuscular specialist. I would be astounded if you are told ALS is in the differential by a neurologist.

Please try to relax
 
My apologies for posting in a new thread...

I also would like to express my appreciation of those that have taken the time to respond. I can only imagine what you have gone through, and the kind hearts you must have to take the time out to respond to everyone’s fears. This world could use a whole lot more kindness and understanding. I truly hope that I would be able to do the same thing if I found myself in your situation. I will make sure to pay your kindness forward...

I will be scheduling an appointment with a therapist to help me cope with my anxiety while I wait for a referral to the neurologist.

I have one other question that I don’t know whether anyone can offer any insight to...

When the findings mention, “polyphasic potentials in multiple, bilateral nerve root distributions”, does it make it more troubling that the polyphasic potentials were found in MULTIPLE and BILATERAL nerve root distributions?
 
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No, esp. because only 3 muscles were tested from what you posted, all in your lower legs, representing 3 nerve roots. In that context, the "multiple, bilateral" characterization is a bit over the top. It's like saying, "the chocolate ice cream sold out in five minutes" when there were only 3 containers to begin with.
 
Thank you all for your feedback...

I have one other question, that I’m hoping you could maybe help me with?

I don’t yet know when the appointment with the neuromuscular specialist will be, but I do want to be as prepared as possible to make sure that the appointment is as efficient as possible, and to make sure I obtain answers to all relevant questions. I plan to take my husband with me, because I know I had trouble processing the information during the EMG once the neurologist said “it’s abnormal”.

With that said, I’m working on a chronology of my symptoms, and I want to go in with a well prepared list of questions.

If you were in my situation, what would you ask?

I truly can’t express my appreciation of each and every one of you for the kindness you have shown me in taking time out of your lives to help me.
 
I think you’re already well-prepared. I do recommend assembling and hand-carrying all your records to the appointment including labs, any MRI results, EMG results, etc— anything that pertains to your current problem.

By all means, write down a chronology of your symptoms as well as any questions you may have (including some of the ones you raised here). The specialist will likely ask you some additional questions, do an exam, review any test results you’ve had, and likely repeat some or all of the EMG.
 
What Nikki said- I would be astounded if ALS was placed in the differential by a Neurologist. GP’s seem to put ALS in play far more frequently than Neurologists.

My guess is you are going to live to be a Grandmother. I’m sorry for the scare, but I think it’s going to be okay.
 
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